JMIR Publications

ABSTRACT

Background:

Adolescent substance use remains a significant public health issue, with schools playing a critical role in prevention efforts.

Objective:

This study developed and evaluated an interactive digital intervention aimed at improving illegal drug-related knowledge, health literacy, and learner engagement for substance use prevention among senior high school students.

Methods:

A baseline and post-test after intervention design was employed, initially involving 768 students aged 16–18 years from nine senior high schools randomly assigned at the school level into an Interactive Digital Intervention Group (IDI Group, n=379) and Traditional Didactic Group (TD group, n=389). Due to attrition and absences, the final analysis included 651 students (IDI group: n=305; TD group: n=346). The IDI group received an Online Substance Use Prevention, a six-unit interactive digital intervention, while the TD group received traditional textbook-based instruction. Outcomes were analyzed using paired t-tests and generalized estimating equations (GEE), adjusting for gender and age differences.

Results:

Intra-groups comparison revealed that the IDI Group revealed significantly greater improvements in the following variables: knowledge (t=-5.23, P<.01), health literacy (t=-3.18, P<.01), functional literacy (t= -3.50, P< .01), critical literacy (t=-2.79, P=.01), communicative literacy (t=-2.26, P=.02), learner engagement (t=-3.40, P<.01) including cognitive engagement (t=-2.20, P=.03) and emotional engagement (t=-3.84, P<.01). Intra-group comparison, inter-group comparison, and GEE analyses were generally consistent with the paired t-test findings, with the exception of cognitive engagement.

Conclusions:

The findings support the effectiveness of an interactive digital intervention in enhancing students’ knowledge, health literacy, and learner engagement, offering a promising approach for school-based substance use prevention programs.